| NPI | 1598225880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MO 2023010491) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: IL 036164462) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-09-03 |